Friday, April 05, 2013

Drug companies are paying an estimated £40m a year to British doctors in service fees, flights, hotel and other travel expenses, according to the trade body that represents pharmaceutical companies.

The Association of the British Pharmaceutical Industry (ABPI) said that most of the 44 biggest companies had now revealed how much they paid doctors to help market their drugs. Its aggregated total of £40m is based on 35 suppliers who have shared precise information with the body and estimates for the rest.

The largest British group, GlaxoSmithKline, spent £1.9m on fees for advice and consultancy on 1,517 UK-based doctors, an average of £1,252 each. It also sponsored 1,022 doctors and other healthcare professionals to attend scientific conferences and meetings, at a total cost of £887,294 – an average of £868 per trip.

Doctors have always denied that taking drug company money influences their judgement in any way about a medicine, but suspicions have lingered.

Doctors sometimes ask for sponsorship to go to international meetings, which they argue they need to attend to keep up with developments in their field. Their hospitals cannot afford to pay their flights and hotel bills, they say.

Thousands of doctors have their flights, registration fees and hotels paid for when they attend major international conferences on cancer or cardiology. They are transported to top restaurants by their sponsoring company and socialise with its staff. Many of the speakers who take to the platform to talk about the benefits of new medicines are senior doctors who are earning a consultancy fee from a pharmaceutical firm.

AstraZeneca, the other major British company, separates out the payments from its UK office and those from its "global teams and international affiliates". The UK office paid £671,400 in fees to 903 doctors plus £30,200 for their travel and hotel bills. Some doctors carried out more than one engagement. Their average earnings including expenses came to £776.96.

But those who were paid by the global teams did far better. A total of £563,000 including expenses was paid out to 93 individuals, giving an average of £6,053.76. However, the 93 people were involved in 304 activities, which gave them an average fee, including expenses, of £1,851.97.

Unlike AstraZeneca, GSK said it had added in payments from its offices abroad, because many of the doctors who receive payment for advice and consultation are global experts.

AstraZeneca, however, did not sponsor any doctors to go to conferences in 2012, a major departure for a pharmaceutical company, because the bad publicity surrounding drug company junkets made it rethink its policy.

In 2005, the Commons health select committee warned in a report that the industry's sponsorship of doctors and other medical staff had drug promotion as its motive and could lead to the unsafe prescribing of drugs such as Vioxx, the arthritis drug which was found to cause heart attacks.

AstraZeneca only supports "a limited number of doctors to attend international conferences in connection with contracted services", it said, which means they would earn fees for speaking rather than being sponsored to listen.

It said it was not offering lavish expenses. "We have embedded robust controls in our process for supporting travel and accommodation to ensure that it is only provided in a lawful manner that is consistent with our commitment to integrity," AstraZeneca said.

Andrew Powrie-Smith, director of the ABPI, said he did not think having to publish what the pharmaceutical industry spent on doctors would tend to make most companies less generous.

Powrie-Smith said: "Industry in the UK is proud of its collaboration with health professionals. A fifth of the top 100 medicines in the UK have come from this collaboration. But there is increasing demand for transparency in the relationship. I don't see that it will have a particularly negative impact over their willingness to support medical education."

At the moment, drug companies are only required to publish their total outlay on doctors. By 2016, however, the European trade body is expecting them to publish the names of the individual doctors they pay. If this happens, the industry will have moved further and faster than the NHS on transparency. All hospital trusts are supposed to keep a register of payments to their staff in case of conflicts of interest, but not all are complete and they are not always available to the public.

The ABPI agreed in 2010 that all companies would publish their total payments to healthcare professionals.

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Call me Jack

The term "PR" means something completely different to a medical doctor!
"We are all born ignorant, but one must work hard to remain stupid." -Benjamin Franklin.
"It takes a wise doctor to know when not to prescribe."
- Gracian.